Severe periodontitis and orthodontics: How far should we go?

Severe forms of periodontitis can often result in pathological tooth migration. In such cases, orthodontic realignment is an indispensable complement to periodontal management. However, in some cases involving very advanced periodontal destruction, the question arises as to the limits of conservative treatment. Are the results of orthodontic periodontic treatment stable over time? All orthodontic treatment must be preceded by reduction of the inflammation. This paper uses clinical cases to illustrate each step to be followed in the periodontal therapeutic process in order to achieve successful orthodontic-periodontal treatment from etiologic therapy to surgical decontamination and long-term periodontal follow-up.

Severe periodontitis and orthodontics: evaluation of long-term results.

UNLABELLED: Clinical manifestations of severe periodontitis are very often associated with tooth migration. The aim of this retrospective study is to evaluate dental bone support before orthodontic-periodontal treatment, at immediate postoperative, and long-term postoperative and to compare these results with those obtained from periodontal treatment alone. Fifteen patients (11 women and four men), all with severe periodontitis, mean age 42.8 years (22-61), were followed for an average of 16 years (11-32). Comparison was made between periodontal-orthodontic treatment (Group 1) and periodontal treatment alone (Group 2). Alveolar bone height was measured at T0 (before treatment), T1 (immediate postoperative) and T2 (long-term postoperative). Assessment was performed by means of digitized radiography using Image J Software from the National Institute of Health. The average postoperative observation period between T0 (before treatment) and T2 (long-term results) was 16 years (11 to 32). Results showed an overall bone apposition in groups (1 and 2) immediately after treatment (T1), then at long-term (T2). No statistical difference was observed between both groups (1 and 2). IN CONCLUSION: an overall bone gain was observed in both treatment groups (periodontal-orthodontic and periodontal alone). The orthodontic treatment combined with periodontal treatment never compromised the benefits of periodontal treatment alone. On the opposite, it appeared to be quite beneficial.